NEWS

Malaria Elimination within Sight in Asia Pacific

October 30, 2012

UCSF and partners showcase their work and regional progress toward malaria elimination at a major international conference in Sydney, Australia.

From October 31 to November 2, 2012, the Australian government will host Malaria 2012: Saving Lives in the Asia-Pacific in Sydney, Australia, to showcase progress throughout the Asia Pacific region in controlling and eliminating malaria. The conference will bring together Ministers of Health and Foreign Affairs from many of the 22 malarious countries in the region, as well as regional and international partners including the US government and UN Special Envoy for Malaria, to invigorate and promote international action to achieve the ultimate goal of eliminating the disease from the entire region.

Malaria continues to be a major public health threat in the region, killing an estimated 43,492 people in 2010 in the Asia Pacific and causing a major drain on productivity and family livelihoods due to illness and lost work. Thanks to significant global, regional and domestic investment and intensive efforts in many countries, however, malaria is being brought under control. For example, from 1994 to 2010, Bhutan's malaria program achieved a 98.7% reduction in cases - a success attributable to strategically targeting interventions for higher-risk populations. Sri Lanka has slashed malaria by 99.9%, from about 265,000 cases in 1999 to only 124 local cases in 2011, despite decades of civil war. Across a group of 14 countries that comprise the Asia Pacific Malaria Elimination Network, or APMEN (Bhutan, Cambodia, China, Democratic People's Republic of Korea, Indonesia, Malaysia, Nepal, Philippines, Republic of Korea, Solomon Islands, Sri Lanka, Thailand, Vanuatu and Vietnam), all of which have national or subnational goals for malaria elimination, total malaria cases have been more than halved (58%) from 2000 to 2010. Three countries (Indonesia, Nepal and Vietnam) account for nearly 70% of the drop. The 14-country APMEN network works to advocate for and support malaria elimination in the Asia Pacific, and has emerged as a powerful forum to address shared challenges and harness collective resources among its member countries.

In light of this progress, Malaria 2012 seeks to set a bold goal for the Asia Pacific countries and their governments: to completely eliminate the disease from half of the 22 malaria-burdened countries in the Asia Pacific by 2025. Sir Richard Feachem, Director of the UCSF Global Health Group and co-chair of APMEN, thinks this aim is ambitious but achievable. "Our vision is a malaria-free Asia Pacific region, and with the right blend of scientific rigor, program consistency and sustained commitment, we should be able to eliminate malaria in 11 countries within the next 13 years," says Feachem. "Several Asia Pacific countries are closing in on the elimination finish line – we, the global health community and world at large, need to ensure the political and financial resources to complete that final mile."

Many of these national and regional elimination efforts are being supported through the work of the UCSF Global Health Group, whose Malaria Elimination Initiative has worked since 2007 to provide intellectual and practical guidance, as well as support, to the 34 countries around the world that are working to eliminate malaria. The Global Health Group helped to catalyze the formation of APMEN in 2009, and serves as its joint-secretariat with the University of Queensland, supporting the network's programs to advance and advocate for malaria elimination with a key focus on Plasmodium vivax, the most prevalent– and more difficult to treat - form of malaria in the region.

At the country level, the Global Health Group has worked with the University of Queensland and the Australian Government to support the Pacific Malaria Initiative (PacMI), which aims to eliminate malaria province-by-province in the Solomon Islands and Vanuatu. In addition to collaborating with APMEN countries and partners to conduct new research to improve surveillance and tools for malaria elimination, the Global Health Group has also worked to document the program histories and strategies of many APMEN countries through briefings, academic papers and case studies.

The Global Health Group's Malaria Elimination Initiative Lead, Dr. Roly Gosling, also contributed to a forthcoming Progress & Impact Series report from the Roll Back Malaria (RBM) Partnership, entitled Defeating Malaria in the Americas, Europe, the Middle East and the Pacific, which will be released November 2. The Global Health Group contributed to the design and focus of the Malaria 2012 conference, and much of the Group's work, as well as the work of APMEN, will be on display.

Nonetheless, the region faces several looming challenges – especially if complacency emerges amidst such widespread success. Malaria strains resistant to first-line anti-malaria drugs are spreading, threatening to reverse the region's accomplishments. Sustained funding prospects for malaria control programs are less certain, especially as financing mechanisms from international agencies face restructuring and reduced funding. In a study published earlier this year, Global Health Group researchers and colleagues found that 91% of all malaria resurgences followed the weakening of malaria programs caused by reduced program funding.

Feachem is confident that the Asia Pacific could realistically reach the final finish line of malaria elimination throughout the Asia Pacific within our lifetimes – provided the region can sustain its political commitment and investments to reaching zero malaria. Such regional focus and collaboration is critical, especially in light of spreading anti-malarial drug resistance. The Malaria 2012 conference - to which the Global Health Group contributed its expertise – will be a major step toward ensuring this critical commitment.